Biologic drugs induced vitiligo: case reports and review of literature

Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF...

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Vydané v:Frontiers in immunology Ročník 15; s. 1455050
Hlavní autori: Shao, Xinyi, Chen, Tingqiao, Pan, Xingyu, Chen, Shuang, Chen, Yangmei, Chen, Jin
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland Frontiers Media SA 17.12.2024
Frontiers Media S.A
Predmet:
Adolescent
Aged, 80 and over
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Atopic dermatitis
Biological products
Biological Products - adverse effects
Biological Products - therapeutic use
biological therapy
Case reports
Crohn's disease
cytokine imbalance
Dermatitis
Dermatitis, Atopic - drug therapy
Drug development
Drug dosages
dupilumab-induced vitiligo
Erythema
Female
Females
Fungal infections
Helper cells
Homeostasis
Humans
Immunology
Inflammatory diseases
inflammatory skin diseases
Legs
Literature reviews
Lymphocytes T
Male
Patients
Psoriasis
Rheumatoid arthritis
Steroids
Tumor necrosis factor
Vitiligo
Vitiligo - chemically induced
atopic dermatitis
inflammatory skin diseases
dupilumab-induced vitiligo
biological therapy
cytokine imbalance
ISSN:1664-3224, 1664-3224
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Abstract Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF α and anti-IL17 drugs. Dupilumab, an IL-4 receptor alpha antagonist used in moderate to severe AD, rarely induces vitiligo. This study reports two cases of new-onset vitiligo following dupilumab treatment for AD. The first case involves an 80-year-old male who developed vitiligo patches appeared on the chest, back, and lower limbs after 2 months of dupilumab therapy. Despite discontinuation of dupilumab, the vitiligo did not regress. The second case describes a 14-year-old female who experienced depigmentation on her forehead one month into dupilumab treatment, with partial improvement of vitiligo lesions over time despite continued therapy. This phenomenon may be due to dupilumab blocking type 2 inflammation, disrupting normal skin homeostasis, and exacerbating type 1 inflammation. These cases, supplemented with a literature review, highlight the potential for biologic drug-induced vitiligo and underscore the need for awareness of such adverse events in clinical practice. The mechanisms underlying this phenomenon likely involve disruption of the Th1/Th2/Th17 cytokine balance, suggesting that targeted therapies may inadvertently exacerbate type 1 inflammation, leading to vitiligo. With the rising use of biologics, clinicians should carefully consider the risk of vitiligo when prescribing these treatments.
AbstractList Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF α and anti-IL17 drugs. Dupilumab, an IL-4 receptor alpha antagonist used in moderate to severe AD, rarely induces vitiligo. This study reports two cases of new-onset vitiligo following dupilumab treatment for AD. The first case involves an 80-year-old male who developed vitiligo patches appeared on the chest, back, and lower limbs after 2 months of dupilumab therapy. Despite discontinuation of dupilumab, the vitiligo did not regress. The second case describes a 14-year-old female who experienced depigmentation on her forehead one month into dupilumab treatment, with partial improvement of vitiligo lesions over time despite continued therapy. This phenomenon may be due to dupilumab blocking type 2 inflammation, disrupting normal skin homeostasis, and exacerbating type 1 inflammation. These cases, supplemented with a literature review, highlight the potential for biologic drug-induced vitiligo and underscore the need for awareness of such adverse events in clinical practice. The mechanisms underlying this phenomenon likely involve disruption of the Th1/Th2/Th17 cytokine balance, suggesting that targeted therapies may inadvertently exacerbate type 1 inflammation, leading to vitiligo. With the rising use of biologics, clinicians should carefully consider the risk of vitiligo when prescribing these treatments.
Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF α and anti-IL17 drugs. Dupilumab, an IL-4 receptor alpha antagonist used in moderate to severe AD, rarely induces vitiligo. This study reports two cases of new-onset vitiligo following dupilumab treatment for AD. The first case involves an 80-year-old male who developed vitiligo patches appeared on the chest, back, and lower limbs after 2 months of dupilumab therapy. Despite discontinuation of dupilumab, the vitiligo did not regress. The second case describes a 14-year-old female who experienced depigmentation on her forehead one month into dupilumab treatment, with partial improvement of vitiligo lesions over time despite continued therapy. This phenomenon may be due to dupilumab blocking type 2 inflammation, disrupting normal skin homeostasis, and exacerbating type 1 inflammation. These cases, supplemented with a literature review, highlight the potential for biologic drug-induced vitiligo and underscore the need for awareness of such adverse events in clinical practice. The mechanisms underlying this phenomenon likely involve disruption of the Th1/Th2/Th17 cytokine balance, suggesting that targeted therapies may inadvertently exacerbate type 1 inflammation, leading to vitiligo. With the rising use of biologics, clinicians should carefully consider the risk of vitiligo when prescribing these treatments.Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While generally effective and safe, these therapies have been increasingly associated with secondary development of vitiligo, especially with anti-TNF α and anti-IL17 drugs. Dupilumab, an IL-4 receptor alpha antagonist used in moderate to severe AD, rarely induces vitiligo. This study reports two cases of new-onset vitiligo following dupilumab treatment for AD. The first case involves an 80-year-old male who developed vitiligo patches appeared on the chest, back, and lower limbs after 2 months of dupilumab therapy. Despite discontinuation of dupilumab, the vitiligo did not regress. The second case describes a 14-year-old female who experienced depigmentation on her forehead one month into dupilumab treatment, with partial improvement of vitiligo lesions over time despite continued therapy. This phenomenon may be due to dupilumab blocking type 2 inflammation, disrupting normal skin homeostasis, and exacerbating type 1 inflammation. These cases, supplemented with a literature review, highlight the potential for biologic drug-induced vitiligo and underscore the need for awareness of such adverse events in clinical practice. The mechanisms underlying this phenomenon likely involve disruption of the Th1/Th2/Th17 cytokine balance, suggesting that targeted therapies may inadvertently exacerbate type 1 inflammation, leading to vitiligo. With the rising use of biologics, clinicians should carefully consider the risk of vitiligo when prescribing these treatments.
Author Chen, Yangmei
Chen, Shuang
Chen, Tingqiao
Pan, Xingyu
Chen, Jin
Shao, Xinyi
AuthorAffiliation Department of Dermatology, the First Affiliated Hospital of Chongqing Medical University , Chongqing , China
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/39742272$$D View this record in MEDLINE/PubMed
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CitedBy_id crossref_primary_10_3390_life15050684
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crossref_primary_10_1016_j_ejphar_2025_178103
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Keywords atopic dermatitis
inflammatory skin diseases
dupilumab-induced vitiligo
biological therapy
cytokine imbalance
Language English
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Snippet Biological drugs are extensively used to treat various inflammatory diseases, including psoriasis, atopic dermatitis (AD), and rheumatoid arthritis. While...
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StartPage 1455050
SubjectTerms Adolescent
Aged, 80 and over
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Atopic dermatitis
Biological products
Biological Products - adverse effects
Biological Products - therapeutic use
biological therapy
Case reports
Crohn's disease
cytokine imbalance
Dermatitis
Dermatitis, Atopic - drug therapy
Drug development
Drug dosages
dupilumab-induced vitiligo
Erythema
Female
Females
Fungal infections
Helper cells
Homeostasis
Humans
Immunology
Inflammatory diseases
inflammatory skin diseases
Legs
Literature reviews
Lymphocytes T
Male
Patients
Psoriasis
Rheumatoid arthritis
Steroids
Tumor necrosis factor
Vitiligo
Vitiligo - chemically induced
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Title Biologic drugs induced vitiligo: case reports and review of literature
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